, Acute Care Exam 1
Week 1 – EENT
A primary care provider notes painless, hard lesions on a patient’s external ears that expel a white
crystalline substance when pressed. What diagnostic test is indicated?
Rheumatoid factor
Endocrine studies
Biopsy of the lesions
Uric acid chemical profile
A patient has painful oral lesions and the provider notes several white, verrucous lesions in clusters
throughout the mouth. What is the recommended treatment for this patient?
Oral hygiene measures
Nystatin oral suspension
Surgical excision
Oral acyclovir
A patient has sore throat, a temperature of 38.5° C, tonsillar exudates, and cervical lymphadenopathy.
What will the provider do next to manage this patient’s symptoms?
Prescribe empiric penicillin
Perform a rapid antigen detection test
Refer to an otolaryngologist
Order an antistreptolysin O titer
A 61 year old male presents with a 12 hour history of extremely painful left red eye. The patient
complains of blurred vision, haloes around lights, and vomiting. It began yesterday evening. On exam,
the eye is red, tender and inflamed. The cornea is hazy and pupil reacts poorly to light. The most likely
diagnosis in this patient is:
Macular degeneration
Acute angle glaucoma
Increased intracranial pressure
Detached cornea
A patient has recurrent epistaxis without localized signs of irritation. Which laboratory tests may be
performed to evaluate this condition? (Select all that apply.)
CBC with platelets
,BUN and creatinine
PT and PTT
Liver function tests
PT/INR
A patient reports a feeling of fullness and pain in both ears and the practitioner elicits exquisite pain
when manipulating the external ear structures. What is the likely diagnosis?
Chronic otitis externa
Acute otitis externa
Otitis media with effusion
Acute otitis media
Patient has been diagnosed with acute rhinosinusitis. Symptoms began 3 days ago. Based on the most
likely etiology, how should this patient be managed?
Azithromycin and decongestant
Decongestant and analgesic
Levofloxacin
Amoxicillin with clavulanate
The vast majority of rhinosinusitis is of viral etiology, antibiotics would not be helpful and
would only lead to continued antibacterial resistance. If symptoms persist for longer than 10
days, reevaluation is necessary with possible antibiotics at that time
A 20-year-old male of Hispanic descent who reports a history of a cold that resolved 2 weeks ago except
for a dry cough and pain over his right cheek that worsens when he bends down. The patient denies
fever. The patient tells you that he is very allergic to Keflex and erythromycin. Vital signs are stable
except temperature is 99.2°F. Which showed the following conditions is most likely?
Fever secondary to previous viral URI
Acute sinusitis
Acute bronchitis
Hay fever
Patient's symptoms match most closely to acute sinusitis which includes cough, facial pain, low-
grade fever
An adult patient has epiglottitis secondary to a chemical burn. Which medication will be given initially to
prevent complications?
Chloramphenicol biopsyrecu
Dexamethasone
, Metronidazole
Clindamycin
What are factors associated with acute suppurative parotitis? (Select all that apply.)
Anticholinergic medications
Diabetes mellitus
Radiotherapy
Hypervolemia
Allergies
A 39 year old has a sudden onset of painful right red eye. He reports sensitivity to light and the
sensation of a foreign body, though his history for a foreign body is negative. He does not wear contact
lenses. How should the NP manage this?
Observe for 24 hours if visual acuity is normal
Treat for bacterial conjunctivitis
Treat for viral conjunctivitis
Refer to ophthalmology
No clear diagnosis can be made from signs/symptoms, but there are several red flags.
collectively the red flags necessitate a referral. There is no mention of eye discharge necessary
for conjunctivitis. Red flags present point more towards active corneal process although
glaucoma should also be a differential.
A 17-year-old has a complaint of ear pain. If he has otitis externa, which complaint is most likely/most
common?
Concurrent URI
Fever
Difficulty hearing TV
Tragal pain
A patient has an initial episode otitis external associated with swimming. The patient’s ear canal is mildly
inflamed and the tympanic membrane is not involved. Which medication will be ordered?
Cipro HC
Neomycin
Fluconazole
Vinegar and alcohol
Week 1 – EENT
A primary care provider notes painless, hard lesions on a patient’s external ears that expel a white
crystalline substance when pressed. What diagnostic test is indicated?
Rheumatoid factor
Endocrine studies
Biopsy of the lesions
Uric acid chemical profile
A patient has painful oral lesions and the provider notes several white, verrucous lesions in clusters
throughout the mouth. What is the recommended treatment for this patient?
Oral hygiene measures
Nystatin oral suspension
Surgical excision
Oral acyclovir
A patient has sore throat, a temperature of 38.5° C, tonsillar exudates, and cervical lymphadenopathy.
What will the provider do next to manage this patient’s symptoms?
Prescribe empiric penicillin
Perform a rapid antigen detection test
Refer to an otolaryngologist
Order an antistreptolysin O titer
A 61 year old male presents with a 12 hour history of extremely painful left red eye. The patient
complains of blurred vision, haloes around lights, and vomiting. It began yesterday evening. On exam,
the eye is red, tender and inflamed. The cornea is hazy and pupil reacts poorly to light. The most likely
diagnosis in this patient is:
Macular degeneration
Acute angle glaucoma
Increased intracranial pressure
Detached cornea
A patient has recurrent epistaxis without localized signs of irritation. Which laboratory tests may be
performed to evaluate this condition? (Select all that apply.)
CBC with platelets
,BUN and creatinine
PT and PTT
Liver function tests
PT/INR
A patient reports a feeling of fullness and pain in both ears and the practitioner elicits exquisite pain
when manipulating the external ear structures. What is the likely diagnosis?
Chronic otitis externa
Acute otitis externa
Otitis media with effusion
Acute otitis media
Patient has been diagnosed with acute rhinosinusitis. Symptoms began 3 days ago. Based on the most
likely etiology, how should this patient be managed?
Azithromycin and decongestant
Decongestant and analgesic
Levofloxacin
Amoxicillin with clavulanate
The vast majority of rhinosinusitis is of viral etiology, antibiotics would not be helpful and
would only lead to continued antibacterial resistance. If symptoms persist for longer than 10
days, reevaluation is necessary with possible antibiotics at that time
A 20-year-old male of Hispanic descent who reports a history of a cold that resolved 2 weeks ago except
for a dry cough and pain over his right cheek that worsens when he bends down. The patient denies
fever. The patient tells you that he is very allergic to Keflex and erythromycin. Vital signs are stable
except temperature is 99.2°F. Which showed the following conditions is most likely?
Fever secondary to previous viral URI
Acute sinusitis
Acute bronchitis
Hay fever
Patient's symptoms match most closely to acute sinusitis which includes cough, facial pain, low-
grade fever
An adult patient has epiglottitis secondary to a chemical burn. Which medication will be given initially to
prevent complications?
Chloramphenicol biopsyrecu
Dexamethasone
, Metronidazole
Clindamycin
What are factors associated with acute suppurative parotitis? (Select all that apply.)
Anticholinergic medications
Diabetes mellitus
Radiotherapy
Hypervolemia
Allergies
A 39 year old has a sudden onset of painful right red eye. He reports sensitivity to light and the
sensation of a foreign body, though his history for a foreign body is negative. He does not wear contact
lenses. How should the NP manage this?
Observe for 24 hours if visual acuity is normal
Treat for bacterial conjunctivitis
Treat for viral conjunctivitis
Refer to ophthalmology
No clear diagnosis can be made from signs/symptoms, but there are several red flags.
collectively the red flags necessitate a referral. There is no mention of eye discharge necessary
for conjunctivitis. Red flags present point more towards active corneal process although
glaucoma should also be a differential.
A 17-year-old has a complaint of ear pain. If he has otitis externa, which complaint is most likely/most
common?
Concurrent URI
Fever
Difficulty hearing TV
Tragal pain
A patient has an initial episode otitis external associated with swimming. The patient’s ear canal is mildly
inflamed and the tympanic membrane is not involved. Which medication will be ordered?
Cipro HC
Neomycin
Fluconazole
Vinegar and alcohol
